SUSAN PUDDY (NPI# 1285146928) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1285146928 |
| Entity Type | Individual |
| Full Name | SUSAN PUDDY |
| Credential | RN |
| Practice Address |
375 Nw Beaver St Prineville OR 97754-1802 |
| Mailing Address |
7752 Nw Country Loop Prineville OR 97754-8137 |
| Practice Telephone | 5414475165 |
| Mailing Telephone | 5414471947 |
| Enumeration Date | 2017-11-03 |
| Last Update Date | 2017-11-03 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 163WG0000X |
Registered Nurse Specialization: General Practice |
200140686RN | OR | Nursing Service Providers |
| Street Address |
375 NW BEAVER ST |
| City | PRINEVILLE |
| State | OR |
| Zip Code | 97754-1802 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1073523122 | Linda Hatch | Nurse Practitioner | 375 Nw Beaver St, Prineville, OR 97754-1802 | 2006-08-09 |
| 1346785318 | Wendy Perrin | Registered Nurse | 375 Nw Beaver St, Prineville, OR 97754-1802 | 2016-12-30 |
| 1174066963 | Mosaic Medical Dental | Clinic/Center | 375 Nw Beaver St, Suite 101, Prineville, OR 97754-1802 | 2016-11-28 |
| 1699129890 | Megann Dastrup | Dietitian, Registered | 375 Nw Beaver St, Suite 101, Prineville, OR 97754-1802 | 2016-04-14 |
| 1124482070 | Jennifer Damore | Nurse Practitioner | 375 Nw Beaver St, Suite 100, Prineville, OR 97754-1802 | 2016-04-07 |
| 1548644867 | Katrina Simpson | Registered Nurse | 375 Nw Beaver St, Prineville, OR 97754-1802 | 2015-07-16 |
| 1821489873 | Leah Flegel | Registered Nurse | 375 Nw Beaver St, #100, Prineville, OR 97754-1802 | 2015-02-12 |
| 1114359643 | Rebecca G. Lundgren | Registered Nurse | 375 Nw Beaver St, Suite 101, Prineville, OR 97754-1802 | 2013-08-07 |
| 1992047666 | Paula Yvonne | Registered Nurse | 375 Nw Beaver St, Suite 100, Prineville, OR 97754-1802 | 2013-03-20 |
| 1679811954 | Mosaic Medical | Clinic/Center | 375 Nw Beaver St, Suite 101, Prineville, OR 97754-1802 | 2013-01-22 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1598246290 | Phyllis Louise Young | Physical Therapy Assistant | 350 Ne Brennan Ln, Prineville, OR 97754 | 2018-08-22 |
| 1316424518 | Monte Bainbridge | Counselor | 1103 Ne Elm St Ste B, Prineville, OR 97754 | 2018-07-20 |
| 1841739760 | Gregory Wayne Sanders | Marriage & Family Therapist | 445 Nw 3rd Street, Prineville, OR 97754 | 2017-02-13 |
| 1114474962 | Amy R Duryea | Counselor | 1103 Ne Elm St., Prineville, OR 97754 | 2016-09-08 |
| 1669855052 | Rebecca L Griffith | Mechanotherapist | 298 N Holly St, Prineville, OR 97754 | 2015-07-02 |
| 1376810838 | Jessica Lynn Neely | Counselor | 1333 Nw 9th Street, Prineville, OR 97754 | 2011-11-28 |
| 1205076130 | Dean Arthur Laney | Registered Nurse | 375 Nw Beaver St., Suite 100, Prineville, OR 97754 | 2009-03-05 |
| 1699910513 | Ross E Weakley | Acupuncturist | 298 Sw Harwood, Prineville, OR 97754 | 2008-12-05 |
| 1326208752 | Laura Danielle Gratton | Family Medicine | 975 Nw Beaver Street, Prineville, OR 97754 | 2008-06-10 |
| 1811174550 | Central Oregon Eyecare, PC | Optometrist | 198 Ne Combs Flat Rd, Ste 120, Prineville, OR 97754 | 2008-01-24 |
| Find all providers in zip 97754 | ||||
| Taxonomy Code | 163WG0000X |
| Grouping | Nursing Service Providers |
| Classification | Registered Nurse |
| Specialization | General Practice |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1376181313 | Silvia Maciel | Registered Nurse | 1151 May St Ste 201, Hood River, OR 97031-1526 | 2019-12-19 |
| 1982124970 | Brenda Backhaus | Registered Nurse | 5935 Sladen Ave, Gladstone, OR 97027-1952 | 2017-06-21 |
| 1568906550 | Nancy Jane Spiegel | Registered Nurse | 13925 Sw Bonnie Brae Ct, Beaverton, OR 97005-4320 | 2016-12-08 |
| 1356707624 | Timothy Lee Unger | Registered Nurse | 3785 Se 317th Ave, Troutdale, OR 97060-9401 | 2016-01-02 |
| 1376888479 | Jill Marie Riffe | Registered Nurse | 10633 Se Flavel St, Portland, OR 97266-6026 | 2012-11-30 |
| 1124319306 | Julie Ann Brown | Registered Nurse | 2765 Sw 24th St, Gresham, OR 97080-5207 | 2011-04-22 |
| 1922215698 | Ellen G. Frichette | Registered Nurse | 1339 Ne Ford St, Mcminnville, OR 97128-3634 | 2007-05-16 |
| 1942256730 | Elaine Marian Hooper | Registered Nurse | 385 Ranch Road, Reedsport, OR 97467 | 2006-05-25 |
| 1285698555 | Jacqualine M Terrill Cooke | Registered Nurse | 320 Se Baker St, Mcminnville, OR 97128-6038 | 2006-04-13 |
| 1083693295 | Sharon Dixie Mcconnell | Registered Nurse | 9911 Se Mount Scott Blvd, Portland, OR 97266-6302 | 2006-01-16 |
| Find all providers with the same taxonomy | ||||
| City | PRINEVILLE |
| Zip Code | 97754 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.